title: Urodynamic effects of oral oxybutynin chloride in children with myelomeningocele and detrusor hyperreflexia.
abstract: OBJECTIVE
  To investigate the effects of oral oxybutynin chloride (OC) on standard urodynamic measures in children with myelomeningocele (MMC) and detrusor hyperreflexia.
  
  
  METHODS
  Forty-one MMC children with detrusor hyperreflexia (19 boys and 22 girls, aged 2 months to 15 years; mean 4.9 years) were evaluated urodynamically before and within 3 months after initiation of oral OC therapy (0.2 to 0.3 mg/kg/day). Therapy with oral OC was always combined with clean intermittent catheterization (CIC).
  
  
  RESULTS
  Oral OC treatment caused an increase in bladder capacity from 141 +/- 96 to 197 +/- 99 mL (+ 40%; P < 0.01), a decrease in detrusor pressure at maximal capacity from 45 +/- 32 to 28 +/- 23 cm H2O (-38%; P < 0.01), and an increase in detrusor compliance from 6.5 +/- 5.6 to 16.8 +/- 13.7 mL/cm H2O (+ 158%; P < 0.01). Improvement in urodynamic measures and continence were correlated. After a follow-up of at least 2 years, effective protection of renal function was achieved in 38 of the 41 children (93%) with conservative therapy alone. Adverse effects resulted in discontinuation of oral OC treatment in only 2 cases.
  
  
  CONCLUSIONS
  Treatment with oral OC and CIC is effective and safe in children with MMC and detrusor hyperreflexia and should be initiated early when indicated by urodynamic findings.
authors.affiliation: Department of Urology, Benjamin Franklin Medical Center, Free University of Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Goessl
authors.forename: H H
authors.initials: HH
authors.lastname: Knispel
authors.forename: U
authors.initials: U
authors.lastname: Fiedler
authors.forename: B
authors.initials: B
authors.lastname: Härle
authors.forename: K
authors.initials: K
authors.lastname: Steffen-Wilke
authors.forename: K
authors.initials: K
authors.lastname: Miller
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008333:Mandelic Acids / Q000008:administration & dosage*; D008591:Meningomyelocele / Q000503:physiopathology*; D012021:Reflex, Abnormal / Q000187:drug effects*; D001743:Urinary Bladder / Q000187:drug effects* / Q000294:innervation / Q000503:physiopathology*; D014563:Urodynamics / Q000187:drug effects*
chemical_list: D018680:Cholinergic Antagonists; D008333:Mandelic Acids; C005419:oxybutynin